CPCS Negligent Credentialing and Legal Risk Management 5

Question 1

A telemedicine physician is credentialed at a distant-site hospital and provides services to a patient at an originating-site critical access hospital. Under CMS rules, what credentialing option is available to the originating site?

Accepted Answer

The originating site may rely on the distant site's credentialing and privileging decisions through a written agreement

Answer

CMS Conditions of Participation permit originating-site hospitals to accept the distant site's credentialing and privileging through a formal written agreement.

Question 2

Which standard of care for negligent credentialing cases is MOST commonly applied by courts when assessing what a hospital 'should have known'?

Accepted Answer

What a reasonably prudent hospital with similar resources would have done

Answer

Courts typically apply a 'reasonably prudent hospital' standard, considering resources and national standards rather than only local practice.

Question 3

A hospital receives a credentialing application from a physician who graduated from a foreign medical school. Which primary source verification step is MOST critical for confirming the validity of the degree?

Accepted Answer

Contacting the Educational Commission for Foreign Medical Graduates (ECFMG)

Answer

ECFMG certification is the authoritative primary source verification for foreign medical graduates' education and training credentials.

Question 4

Under the Ongoing Professional Practice Evaluation (OPPE) framework, data collected on a practitioner must be used for what purpose?

Accepted Answer

To inform reappointment and privilege renewal decisions

Answer

OPPE data is explicitly required to inform decisions about continuation of privileges at reappointment.

Question 5

A state court applies a 'some evidence' standard when a physician challenges a hospital's decision to deny privileges. What does this standard mean for the hospital?

Accepted Answer

The court will uphold the denial if any credible evidence in the record supports it

Answer

The 'some evidence' standard is highly deferential—courts will not second-guess a privilege denial if the record contains any credible supporting evidence.

(CPCS) Certified Professional Credentialing Specialist Practice Test

(CPCS) Certified Professional Credentialing Specialist Practice Test

CPCS Negligent Credentialing and Legal Risk Management 5